Shock : molecular, cellular, and systemic pathobiological aspects and therapeutic approaches : the official journal the Shock Society, the European Shock Society, the Brazilian Shock Society, the International Federation of Shock Societies
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Editorial
Perfluorocarbon Gas Transport: an Overview of Medical History With Yet Unrealized Potentials.
Perfluorocarbon (PFCs) compounds have been a hereto fore under realized pharmaceutical class of intravenous emulsions and respiratory adjuvants researched extensively since the late 1970. This review represents an introduction for a series of more detailed lectures/manuscripts that were part of a combined United States collaborative Federal agency meeting in early February, 2017 at Ft Detrick, MD, focused upon potential technologies in development to fulfill a perceived need: "When blood transfusion is not available." As such, PFCs represent a distinctly different class of pharmaceutical artificial oxygen (and other gas) transporters than are hemoglobin-based oxygen carriers (HBOCs). ⋯ The PFCs should be viewed as pharmaceuticals possessing unique gas solubility and diffusion characteristics such that they may relieve ischemia of tissues with low/flow-no flow states therefore they can enhance tissue salvage while other definitive treatments are being sought. PFCs as short-term enhanced tissue oxygen (and other gas enhancements) delivery vehicles should have varied and potentially game-changing medical potentials.
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Perfluorocarbon emulsions (PFC) are a class of lipid-coated micelle slurries wherein the active center of the micelle is a completely halogen/fluorine-substituted hydrocarbon capable of dissolving very large quantities of nonpolar gases. Due to their unique enhanced solubility for oxygen (O2) and nitrogen (N2), PFCs have been used in research as enhanced gas transport media for situations wherein the microcirculation is dysfunctional. In the early 1990s a PFC emulsion was approved for human use during coronary artery angioplasty and one is presently in use in Russia as well as other countries. ⋯ Although thrombocytopenia has been reported in response to PFC emulsion formulations, it is not ubiquitous and seems to be less associated with some formulations. As well, in some recent animal studies there is no evidence of platelet white cell adverse interactions. The mechanism for the reported thrombocytopenia is as yet not fully understood, and risk-benefit profiles will have to be carefully studied as contemporary human trials move forward.